WO2007079222A2 - Detection de position dans un champ magnetique - Google Patents

Detection de position dans un champ magnetique Download PDF

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Publication number
WO2007079222A2
WO2007079222A2 PCT/US2006/049572 US2006049572W WO2007079222A2 WO 2007079222 A2 WO2007079222 A2 WO 2007079222A2 US 2006049572 W US2006049572 W US 2006049572W WO 2007079222 A2 WO2007079222 A2 WO 2007079222A2
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WIPO (PCT)
Prior art keywords
assembly
encoder
light
recited
optical fiber
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Application number
PCT/US2006/049572
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English (en)
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WO2007079222A3 (fr
Inventor
David Wurmfeld
Matthew S. Solar
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Image-Guided Neurologics, Inc.
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Application filed by Image-Guided Neurologics, Inc. filed Critical Image-Guided Neurologics, Inc.
Priority to EP06849115.8A priority Critical patent/EP1974188B1/fr
Publication of WO2007079222A2 publication Critical patent/WO2007079222A2/fr
Publication of WO2007079222A3 publication Critical patent/WO2007079222A3/fr

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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01D—MEASURING NOT SPECIALLY ADAPTED FOR A SPECIFIC VARIABLE; ARRANGEMENTS FOR MEASURING TWO OR MORE VARIABLES NOT COVERED IN A SINGLE OTHER SUBCLASS; TARIFF METERING APPARATUS; MEASURING OR TESTING NOT OTHERWISE PROVIDED FOR
    • G01D5/00—Mechanical means for transferring the output of a sensing member; Means for converting the output of a sensing member to another variable where the form or nature of the sensing member does not constrain the means for converting; Transducers not specially adapted for a specific variable
    • G01D5/26—Mechanical means for transferring the output of a sensing member; Means for converting the output of a sensing member to another variable where the form or nature of the sensing member does not constrain the means for converting; Transducers not specially adapted for a specific variable characterised by optical transfer means, i.e. using infrared, visible, or ultraviolet light
    • G01D5/32—Mechanical means for transferring the output of a sensing member; Means for converting the output of a sensing member to another variable where the form or nature of the sensing member does not constrain the means for converting; Transducers not specially adapted for a specific variable characterised by optical transfer means, i.e. using infrared, visible, or ultraviolet light with attenuation or whole or partial obturation of beams of light
    • G01D5/34—Mechanical means for transferring the output of a sensing member; Means for converting the output of a sensing member to another variable where the form or nature of the sensing member does not constrain the means for converting; Transducers not specially adapted for a specific variable characterised by optical transfer means, i.e. using infrared, visible, or ultraviolet light with attenuation or whole or partial obturation of beams of light the beams of light being detected by photocells
    • G01D5/347—Mechanical means for transferring the output of a sensing member; Means for converting the output of a sensing member to another variable where the form or nature of the sensing member does not constrain the means for converting; Transducers not specially adapted for a specific variable characterised by optical transfer means, i.e. using infrared, visible, or ultraviolet light with attenuation or whole or partial obturation of beams of light the beams of light being detected by photocells using displacement encoding scales
    • G01D5/34707—Scales; Discs, e.g. fixation, fabrication, compensation
    • G01D5/34715—Scale reading or illumination devices
    • G01D5/34723—Scale reading or illumination devices involving light-guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A61B2017/3405—Needle locating or guiding means using mechanical guide means
    • A61B2017/3409—Needle locating or guiding means using mechanical guide means including needle or instrument drives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2059—Mechanical position encoders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/062—Measuring instruments not otherwise provided for penetration depth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/374—NMR or MRI
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937—Visible markers
    • A61B2090/3945—Active visible markers, e.g. light emitting diodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00—Metal working
    • Y10T29/49—Method of mechanical manufacture
    • Y10T29/49826—Assembling or joining

Definitions

  • This application pertains generally to monitoring the position of a surgical instrument. More particularly, but not by way of limitation, this patent document pertains to remote position detection of a surgical instrument in the presence of a magnetic field.
  • MRI magnetic resonance imaging
  • neurosurgery involves making a drill hole in the relatively thick bony structure surrounding the brain (i.e., the skull).
  • the drill hole is made by a surgeon at a desired entry point using a surgical drill.
  • the surgeon then typically guides (e.g., using trajectory guide tubes) one or more surgical instruments or observation tools (e.g., electrodes — recording or stimulating, cannulas, needles, biopsy instruments, catheters or other types of probes or devices) through the entry hole to the specific targets within the brain.
  • surgical instruments or observation tools e.g., electrodes — recording or stimulating, cannulas, needles, biopsy instruments, catheters or other types of probes or devices.
  • At least two challenges involved in neurosurgery include staying oriented within the brain, and directing instruments to a desired depth therein.
  • both the aiming of the instrument guide and the subsequent introduction of the instrument are conducted while a patient's skull is positioned within an enclosure (i.e., a bore) of an MRI scanner.
  • an MRI scanner Through the use of the MRI scanner, the surgeon is able to verify the orientation of each instrument introduced.
  • the surgeon is currently unable to also remotely determine the position (e.g., depth) of the instrument introduced. Instead, to determine the depth of the instrument, the surgeon must leave his/her position near an imaging display and enter the MRI-generated magnetic field and manually read the instrument depth.
  • Some drawbacks of the MRI technique are rooted in the fact that the corresponding magnetic field often presents problems with electrical components, such as the electrical components of conventional electronic measuring apparatus.
  • the use of electrical components may not work in the strong magnetic field surrounding an MRI scanner for at least three reasons. First, their components (e.g., metal wires, electrical components, etc.) may experience a force in the magnetic field, creating a safety hazard for the patient. Second, the accuracy with which such components operate may be affected by the magnetic field. Third, it puts patients at risk for burns due to eddy currents generated within conductive components.
  • An assembly may be provided for detecting a position of a surgical instrument in a magnetic field.
  • the assembly may generally comprise an encoder, a light source, and. a light detector array.
  • the encoder has an encoder first side and an oppositely positioned encoder second side, and the encoder includes a translucent substrate and one or more light blocking indicia disposed thereon.
  • At least one input optical fiber extends from an input fiber first end to an input fiber second end, with the input fiber first end coupled to the light source and the input fiber second end disposed at a point adjacent the encoder first side.
  • At least one output optical fiber extends from an output fiber first end to an output fiber second end, with the output fiber first end disposed at a point adjacent the encoder second side and the output fiber second end coupled to the light detector array.
  • a method of detecting a position of a surgical instrument may also be provided.
  • the method generally comprises (a) moving an encoder including a translucent substrate and one or more light blocking indicia in concert with the surgical instrument; (b) illuminating the encoder using a light source by way of at least one input optical fiber, wherein movement of the one or more light blocking indicia disposed on the translucent substrate interrupts light from passing through the encoder; (c) detecting the light passed through the encoder using a light detector array by way of at least one output optical fiber; and (d) determining one or both of a relative or an absolute position of the surgical instrument.
  • FIG. 1 is a schematic view illustrating an assembly for providing remote position detection in a magnetic field, as constructed in accordance with at least one embodiment.
  • FIG. 2A is a schematic view illustrating exemplary imaging planes made possible through the use of MRI techniques.
  • FIG. 2B illustrates exemplary MRI-produced planar images of a subject's brain including one or more diseases or defects.
  • FIG. 3 is a schematic view illustrating an assembly for providing remote position detection in a magnetic field, as constructed in accordance with at least one embodiment.
  • FIG. 4 is a block diagram illustrating portions of an assembly for providing remote position detection in a magnetic field, as constructed in accordance with at least one embodiment.
  • FIG. 5 is an isometric view illustrating portions of an assembly for providing remote position detection in a magnetic field coupled to an instrument drive and trajectory guide assembly, as constructed in accordance with at least one embodiment.
  • FlG- 6 is an isometric view illustrating portions of an assembly for providing remote position detection in a magnetic field coupled to an instrument drive and trajectory guide assembly, as constructed in accordance with at least one embodiment.
  • FIG. 7 is an isometric view illustrating portions of an assembly for providing remote position detection in a magnetic field, as constructed in accordance with at least one embodiment.
  • FIG. 8 A is an isometric view illustrating components of a single optical fiber, as constructed in accordance with at least one embodiment.
  • FIG. 8B is a simplified cross-sectional view illustrating total internal reflection in an. optical fiber.
  • FIG. 9 is a flow diagram illustrating a method of fabricating an assembly for providing remote position detection in a magnetic field, as constructed in accordance with at least one embodiment.
  • FIG. 10 is a flow diagram illustrating a method of detecting a position of a surgical instrument, as constructed in accordance with at least one embodiment.
  • the position (e.g., depth) of such instruments being introduced is also important.
  • a neurosurgeon may first introduce a brain-activity recording electrode to a particular depth within the brain that exhibits a desired degree of brain- activity. The neurosurgeon may then want to remove the recording electrode and introduce a drug or cell delivery catheter or stimulation electrode to that same depth.
  • the surgeon is able to verify the orientation of the instruments being introduced. Unfortunately, however, the surgeon is currently unable to also remotely determine the depth of the instruments being introduced due to problems the (MRI-generated) magnetic field creates with components of conventional electronic measuring techniques.
  • the present assemblies and methods provide the capability of optically encoding an instrument's depth (i.e., converting the mechanical position of the instrument into representative electrical signals by means of, among other things, a patterned scale, a light source and photosensitive elements) in the presence of the (typically) strong magnetic field associated with a MRI scanner or similar, such that the depth information can be conveyed to a neurosurgeon located remotely, i.e., outside of the magnetic field.
  • the present assemblies and methods by carrying optical signals (via one or more optical fibers) in lieu of (conductive) electrical components, avoid the drawbacks associated with MRI-generated magnetic fields. (Notably, optical fibers transmit light rather than electrons and therefore, neither radiates magnetic fields nor is susceptible to magnetic fields surrounding it).
  • the present assemblies and methods include adequate patient isolation (e.g., from eddy currents) with good instrument performance.
  • the present assemblies and methods are easy and economical to manufacture, maintain, and use.
  • the present assemblies and methods allow for sub-micrometer position resolution (e.g., position +/- 0.5 x 10 ⁇ -6 meters).
  • FIG. 1 is a schematic view illustrating an assembly 100 for providing remote position (e.g., depth) detection of one or more instruments 102 in a magnetic field 104.
  • a subject 106 disposed on a support table 108 is placed in magnetic field 104, which is generated by, for example, a MRI scanner 110.
  • MRI scanner 110 includes one or more magnets 112, which are shown sectioned in half to reveal subject 106 therewithin.
  • Subject 106 is further surrounded by a set of (cylindrical) magnetic field gradient coils 114 (also shown sectioned in half) adapted to create magnetic field gradients of a predetermined strength at predetermined times.
  • Gradient coils 114 generate magnetic field gradients in three mutually orthogonal directions.
  • the MRI scan may begin.
  • the head region of subject 106 (into which instrument 102 is shown inserted) is located in the approximate center of the one or more magnets 112 and gradient coils 114.
  • MRI scanner 110 picks out points inside the subject's brain 118 and asks it, essentially, "what type of tissue are you?" In this way, MRI scanner 110 goes through brain 118 point-by-point, building up a 2-D or 3- D map of tissue types (see FIGS. 2A, 2B). Non-tissue points are also picked up by MRI scanner 110.
  • MRI scanner 110 provides a surgeon 116 with information regarding an orientation of each instrument 102 introduced into subject 106, in addition to diseases or defects of brain 118 (see FIGS. 2 A, 2B).
  • the surgeon 116 was unable to also remotely determine the position of instrument(s) 102 because of the MRI-associated magnetic field 104 and its effect on conductive components required in previous remote position detection assemblies and methods.
  • position detection assembly 100 is shown coupled to a drive and trajectory guide assembly 124 (see, e.g., FIGS. 5, 6) and includes an encoder 126, a light source 128, at least one input optical fiber 120, an input electrical cable 136, a light detector array 130, at least one output optical fiber 122, an output electrical cable 138, and one or both of a first control module 132 or a second control module 134.
  • position detection assembly 100 may be conceptualized as including a light input subsystem, an optical target, and a light output subsystem.
  • the light input subsystem typically includes input electrical cable 136, light source 128, input optical fiber(s) 120, and first control module 132.
  • the optical target typically includes encoder 126 having one or both of relative position indicia or absolute position indicia thereon.
  • the light output subsystem typically includes output optical fiber(s) 122, light detector array 130, output electrical cable 138, and second control module 134. Referring initially to the light input subsystem, in this example, first control module 132 is disposed far enough away from magnetic field 104 surrounding subject 106 so that it neither influences nor is influenced by such field 104 to any appreciable degree.
  • Input electrical cable 136 is connected at one end to module 132 and at the other end to light source 128. Similar to first control module 132, light source 128 is disposed far enough away from magnetic field 104. Input electrical cable 136 transmits electrical signals from first control module 132 to light source 128, which acts as a transducer to convert the electrical signals from the module into light signals.
  • the at least one input optical fiber 120 carries the light signals from light source 128 to a point adjacent a first side of encoder 126. In one example, the at least one input optical fiber 120 includes a plurality of input optical fiber, which carry the light signals from light source 128 to a position near encoder 126.
  • Encoder 126 includes a first side and an oppositely positioned second side.
  • encoder 126 comprises a translucent substrate and one or more light blocking indicia disposed on the substrate.
  • the one or more light blocking indicia disposed on the substrate include two rows of alternating opaque and translucent graduation marks.
  • the two rows of alternating opaque and transparent graduation marks are placed parallel to one another or are placed laterally offset from one another by a fraction of the width of the graduation marks.
  • the fraction of the width of the graduation marks includes a range from one-eighth to one- fourth of the width of the graduation marks, which causes (in one example) a phase shift of approximately thirty-eight degrees between electrical signals generated by light detector array 130.
  • the one or more light blocking indicia include at least one absolute position marker.
  • the at least one absolute position marker may include one or more scanning field tracks and a series of alternative opaque and translucent marks located in the one or more scanning field tracks.
  • the series of opaque and translucent marks may represent a binary number that encodes an absolute position on the translucent scale.
  • the binary number encoding in one example, uses Excess Gray code. In this way, among others, encoder 126 provides an optical target located within magnetic field 104, which light from light source 128 via input optical fiber(s) 120 attempts to pass through.
  • the light output system which comprises at least one output optical fiber 122 for receiving optical (i.e., light) signals extending through encoder 126 and transmitting such light signals outside of magnetic field 104 to light detector array 130.
  • Light detector array 130 acting as one or more photodetectors or photodiodes, converts the light signals received by the at least one output optical fiber 122 to electrical signals impressed on output electrical cable 138.
  • light detector array 130 generates electrical signals representative of each of one or more rows of (alternating opaque and translucent) graduation marks when the rows are scanned by illuminating them with one or more input optical fibers 120 and detecting the light passing through the marks with one or more output optical fibers 122.
  • the representative electrical signals may provide, among other things, information relating to instrument's 102 absolute or relative position (including distance or direction information) or speed upon, for example, as little as 0.1 mm of travel.
  • the absolute position ability of the present assemblies and methods avoids loss of position data upon power-down. This is because the present assemblies can be reinitialized on power-up by searching for an index (i e., one or more absolute indicia marks) and resetting the position counter accordingly.
  • an index i e., one or more absolute indicia marks
  • a user knows where instrument 102 is positioned with little to no error.
  • Output electrical cable 138 is connected at one end to light detector array 130 and at the other end of a second control module 134.
  • Second control module 134 is disposed remotely outside magnetic field 104.
  • first and second control modules 132, 134 may be integral and include a display 140.
  • Display 140 may be configured to enable surgeon 116 to quickly recognize the position (e.g., depth) or orientation information of the one or more instruments 102.
  • magnetic fields 104 such as the radio frequency (referred to as "RF") fields created by MRI scanner 110, have no sharp termination or boundary lines. Accordingly, when an element is "located outside a magnetic field,” it is disposed where the magnetic field does not interfere with operation of the element or operation of the element does not interfere with the function of the magnetic field, c
  • FIGS. 2 A, 2B relate to imagery made possible by MRI scanning techniques.
  • FIG. 2A illustrates exemplary imaging planes 200 made possible by the use of MRI techniques
  • FIG. 2B illustrates exemplary MRI-produced planar images 202.
  • MRI has the ability to image in any plane, such as, planes 200 ⁇ 4, 200S.
  • the imaging capabilities of MRI systems allows a surgeon 116 (FIG. 1) to gain an unparalleled view inside a subject's body 106 (FIG. 1). By changing exar ⁇ parameters, the MRI system can cause tissues in, or foreign instruments 102 introduced into, the body to take on different appearances than their surroundings.
  • FIG. 3 illustrates art enlarged view (relative to FIG. 1) of an assembly
  • position detection assembly 100 for providing remote position (e.g., depth) detection of one or more instruments 102 in the presence of a magnetic field 104.
  • position detection assembly 100 is coupled to a drive and trajectory guide assembly 124 used for, among other things, the introduction and removal of the one or more instruments 102.
  • drive and trajectory guide assembly 124 is described in more detail in associated with FIG. 5 (discussed below) and in commonly assigned Solar et al., U.S. Patent Application Serial No. 11/005,607, entitled “Instrument Guiding Stage Apparatus And Method For Using The Same," which was filed on December 4, 2004 and published on June 08, 2006 as U.S. Patent Publication No. 2006/0122628.
  • position detection assembly 100 generally includes a light input subsystem, an optical target, and a light output subsystem.
  • Light input subsystem comprises a first control module 132, an input electrical cable 136, a light source 128, and one or more input optical fibers 120.
  • Light output subsystem comprises one or more output optical fibers 122, a light detector array 130, an output electrical cable 138, and a second control module 134.
  • Optical target comprises an encoder 126 having one or both of relative position indicia or absolute position indicia disposed thereon.
  • the present assemblies 100 and methods use one or more input optical fibers 120 to transmit light from light source 128 to within magnetic field 104, such as a point adjacent a first side of encoder 126.
  • Ends of these optical fibers 120 are attached to drive and trajectory guide assembly 124 (e.g., via a housing 700, see FIG. 7) and arranged so that the transmitted light is directed toward, and portions of the light through, encoder 126.
  • ends of one or more output optical fibers 122 are attached to drive and trajectory guide assembly 124 (e.g., via a housing 700) and arranged to receive light passing through encoder 126.
  • Encoder 126 by being comprised of a translucent substrate including, for example, glass or plastic with one or more light blocking indicia disposed thereon, allows some rays of light therethrough while blocking others.
  • the present position detection assembly 100 includes an encoder movably mounted relative to one or both of the input optical fibers 120 or the output optical fibers 122 and stationarily mounted relative to the one or more surgical instruments 102 introduced into a subject's brain 118.
  • encoder 126 may be mounted to a second stage 504 (FIG. 5) of drive and trajectory guide assembly 124, while ends of optical fibers 120, 122 are coupled to a first stage 506 (FIG. 5) of assembly 124.
  • movement of the one or more instruments 102 results in movement of encoder 126, which further results in movement of the one or more light blocking indicia disposed on encoder 126.
  • the movement of the light blocking indicia creates a pattern by blocking some light rays from passing through encoder 126 while allowing other light rays to pass through.
  • This pattern of block and unblocked light rays is received by output optical fiber(s) 122 and transmitted out of magnetic field 104 to light detector array 130.
  • Light detector array 130 which may comprise one or more photodetectors or photodiodes, is configured to convert the light signals to representative electrical signals which are then sent to second control module 134 for formulation and conveyance (to surgeon 116 (FIG. I)) of an instrument 102 position.
  • FIG. 4 is a block diagram 400 illustrating portions of an assembly 100 for providing remote position (e.g., depth) detection of one or more instruments 102 (FIG. 1) in a magnetic field 104.
  • a first control module 132 (FIG. 1) produces and sends (via an input electrical cable 136 (FIG. I)) one or more electrical signals to a light source 128, which converts the one or more electrical signals into one or more light signals.
  • the light signals are transmitted, via at least one input optical cable 120, through a lens 702, to an encoder 126 movable (in concert with the one or more instruments 102) in one or more directions 402, 404.
  • encoder 126 includes one or more light blocking indicia 406, such as absolute position indicia 406A or relative position indicia 406B.
  • the light blocking indicia 406 create a unique pattern of emitted light through encoder 126.
  • This unique pattern of emitted light is received by at least one output optical cable 122, after being focused by lens 702, and transmitted to a light detector array 130.
  • Light detector array 130 decodes the unique pattern of emitted light signals and sends electrical signals indicative of an instrument position to a second control module 134 (via an output electrical cable 138).
  • position detection assembly 100 may include one or more optical regenerators to boost the light signals as they travel through optical fibers 120 or 122.
  • the position detection assembly 100 disclosed herein may, in one example, be used in conjunction with a drive and trajectory guide assembly 124, such as that disclosed in commonly assigned Solar et aL, U.S. Patent Application Serial No. 1 1/005,607, filed on December 4, 2004 and published on June 8, 2006 as U.S. Patent Publication No. 2006/0122628.
  • FIGS. S, 6 illustrate how position detection assembly 100 may be used with a drive and trajectory guide assembly 124.
  • FIG. 5 provides an isometric view illustrating portions of position detection assembly 100 coupled to portions of drive and trajectory guide assembly 124.
  • an instrument immobilizer 502 configured to attach to a skull 508 (surrounding brain 118 (FIG. I)) around a drill hole 510, in combination with a trajectory guide 512 couples drive and trajectory guide assembly 124 to a subject 106 (FIG. 1).
  • instrument immobilizer 502 is screwed to skull 508, while trajectory guide 512 is also screwed to the skull outside of immobilizer 502 with separate screws.
  • Trajectory guide 512 is further coupled to an instrument guide 514 on a top side.
  • a top side of instrument guide 514 is configured to allow a drive assembly 516 to be coupled thereto.
  • drive assembly 516 includes a base 518 having a base lumen 520 configured to receive instrument guide 514.
  • a thumb screw 522 or other fixation device extends through base 518 and into base lumen 520 (an axis of which defines an instrument trajectory 526) to engage instrument guide 514 and fixedly couple drive assembly 516 to the same.
  • base 518 includes two guide rails 524A, 524B to which a first stage 506 is coupled.
  • first stage 506 includes a lower portion 528 and an upper portion 530.
  • First stage 506 also includes a first stage lumen which houses retaining assembly 550B.
  • An actuator 552B is coupled to and extends through a portion of first stage 506 to retain one or more instruments 102 (e.g., guide tubes) extending through the first stage lumen.
  • a second stage 504 is movable coupled to first stage 506.
  • second stage 504 is slidably coupled to first stage 506 by a lead screw 532 or the like.
  • Lead screw 532 extends between lower portion 528 and upper portion 530 and includes threads configured to mate with second stage 504.
  • second stage 504 includes a second stage lumen which houses an instrument retaining assembly 550A.
  • An actuator 552A is coupled to and extends through a portion of second stage 504 to retain one or more instruments (e.g., recording electrodes or catheters) extending through the second stage lumen.
  • ends of at least one input optical fiber 120 and at least one output optical fiber 122 are coupled to first stage 506 near upper portion 530.
  • An encoder 126 is coupled to second stage 504.
  • encoder 126 is movably mounted relative to both the at least one input optical fiber 120 and the at least one output optical fiber 122.
  • optical fibers 120, 122 are detachably coupled to first stage 506 by way of one or more position assembly housings 700, one example of which is illustrated in FIG. 7.
  • the position detection assembly 100/drive and trajectory guide assembly 124 combination allows a surgeon 116 (FIG.
  • FIG. 6 illustrates an enlarged isometric view (relative to FIG. 5) of an assembly 100 for providing remote position (e.g., depth) detection of one or more instruments 102 in the presence of a magnetic field 104.
  • assembly 100 is coupled to portions of a drive and trajectory guide assembly 124.
  • assembly 124 includes a base 518 from which two guide rails S24A, 524B extend.
  • a second stage 504 is movably coupled to first stage 506, such as by way of a lead screw 532 or the like.
  • Lead screw 532 extends between lower portion 528 and upper portion 530 and includes threads configured to mate with second stage 504.
  • ends of at least one input optical fiber 120 and at least one output optical fiber 122 are coupled to first stage 506, specifically upper portion 530.
  • coupling between optical fibers 120, 122 and first stage 506 occurs via one or more position assembly housings 700 such that portions of the housing(s) face one another. This facing relationship allows light signals transmitted via input optical fiber 120 to pass through, or be blocked by, an encoder 126 and the light pattern received by output optical fiber 122.
  • at least one lens 702 is coupled to one an end of one or both of input optical fiber 120 or output optical fiber 122. The at least one lens 702 is adapted to focus the light to be carried by the respective optical fibers or to focus light onto encoder 126.
  • the spacing between portions of position assembly housing(s) 700 and encoder 126 is 0.5 mm or less. In another example, portions of the position assembly housing(s) 700 are positioned so as to slight touch encoder 126, which may help reduce the parallax problem often associated with optical systems.
  • Encoder 126 shown in FIG. 6 is coupled to second stage 504 between optical fibers 120 and 122. As a result of being coupled to second stage 504, encoder 126 is movable relative to position assembly housing(s) 700 and optical fibers 120, 122 and stationary relative to instrument 102 retained by retaining assembly 550A. As discussed above, encoder 126 comprises a translucent substrate and one or more light blocking indicia 406. In one example, such indicia 406 include a linear array of relative position indicia 406B that provide a light pattern pass through indicative of a relative (e.g., to an absolute reference) position of instrument 102.
  • the one or more light blocking indicia 406 include a linear array of absolute position indicia 406A that provide a light pattern pass through indicative of an absolute position of instrument 102 from, for example, a desired target within brain 118 (FIG. 1).
  • FIG. 7 is an isometric view illustrating portions of an assembly 100 for remotely detecting a position of one or more surgical instruments 102 (FIG. 1) in the presence of a magnetic field 104 (FIG. 1). Specifically, FIG. 7 illustrates an example of a position assembly housing 700 adapted for use in position detection assembly 100.
  • an encoder 126 moves with the one or more instruments 102 being introduced into a subject 106 (FIG. I) by attaching encoder 126 to the instrument 102 itself, or by attaching encoder 126 to an advancing/retracting carriage, such as a second stage 504 (FIG. 6) of a drive and trajectory guide assembly.
  • encoder 126 is translucent except for an array of light-blocking indicia 406, such as absolute position indicia 406A or relative position indicia 406B.
  • a light source 128 (FIG.
  • a light detector array (by way of at least one output optical fiber 122) detects a position of instrument(s) 102 being introduced by reading and decoding the uniquely-identifiable indicia 406 on encoder 126.
  • One or more position assembly housings 700 may be used to couple optical fibers 120, 122 to an instrument introduction assembly, such as a drive and trajectory guide assembly 124 (FIG. 5), and appropriately direct ends thereof to emit and receive light signals.
  • a transmitting/receiving position assembly housing 700 is shown.
  • Housing 700 includes at least one recess in housing portion 700A for holding an end portion of the at least one input optical fiber 120 securable using, for example, an adhesive, and at least one recess 704 (e.g., groove) in housing portion 700B for holding an end portion of the at least one output optical fiber 122.
  • housing 700 may include one or more (polycarbonate) lenses 702 co-molded within housing 700 to focus light from light source 128 into a beam of such diameter that one of the light blocking indicia 406 (FIG. 4) on encoder 126 obstructs the beam from passing through the translucent scale or to focus received light signals into output optical fiber(s) 122.
  • housing 700 includes transmitters or receivers such as HFBT- 1523 or HFBT-2523 manufactured by Agilent Technologies of Palo Alto, CA, USA.
  • housing 700 is composed of a polymer.
  • housing portion 700B is adapted to connect to housing portion 700A via snap projections 706.
  • housing 700 includes a step portion 708 into which encoder 126 may move about (e.g., slide).
  • FIGS. 8A, 8B are directed toward optical fibers, such as the input optical fiber 120 or the output optical fiber 122 discussed above.
  • FIG. 8A illustrates components of a single optical fiber.
  • Each of optical fibers 120, 122 generally speaking, comprises a core 802, a cladding 804, and a buffer coating 806.
  • Core 802 is the thin (glass) center of the fiber where the light signals travel.
  • Cladding 804 is the outer optical material surrounding core 802 that reflects the light back into core 802.
  • Buffer coating 806 is the plastic coating that protects the fiber from, damage.
  • Core 802 and cladding 804 are composed of materials that have different optical transmission properties.
  • An important property of these materials is the index of refraction (typically designed by the letter "n"), a material constant that determines the direction of the light (signals) through the material.
  • the index of refraction of the core 802 must be larger than that of the cladding 804 for the light to travel through the optical fiber.
  • optical fibers 120, 122 allow light signals to be transmitted from light source 128, through one or more lenses 702 and encoder 126, and transmitted to light detector array 130 by constantly bouncing light signals off cladding 804 (FIG. 8A) through core 802 (FIG. 8B) (referred to as "total internal reflection").
  • FIG. 9 is a flow diagram illustrating a method 900 of fabricating a position detection assembly operable in a magnetic field.
  • a first position assembly housing couplable to an instrument introduction assembly e.g., the drive and trajectory guide assembly discussed above
  • Formation of the first position assembly housing includes forming at least one recess for holding an end portion of at least one input optical fiber.
  • a second position assembly housing couplable to the instrument introduction assembly is formed. Formation of the second position assembly housing includes forming at least one recess for holding an end portion of at least one output optical fiber.
  • steps 902 and 904 are combined such that the first and second position assembly housings are integrally formed.
  • the second position assembly housing is disposed (and coupled to the instrument introduction assembly) opposite the first position assembly housing, such that a portion of each assembly housing faces toward one another in an aligned emitting manner.
  • an encoder having an encoder first side and an encoder second side is formed.
  • the encoder includes a translucent substrate and one or more light blocking indicia disposed thereon.
  • the first position assembly housing, the second position assembly housing, and the encoder are composed of one or more non-conductive and non-magnetic materials allowing the device to be operable in a magnetic field, such as the field generated by a MRI scanner.
  • the encoder is positioned between the first and the second position assembly housings, hi one such example, the encoder is movably mounted relative to the first or the second position assembly housings. The movable mounting may occur, among other ways, by mounting the encoder to an advancing/retracting carriage of the instrument introduction assembly (e.g., the second stage of the drive and trajectory guide assembly discussed above).
  • a light source and a light detector array are positioned effectively outside the magnetic field.
  • at least one input optical fiber optically couples the light source and a point adjacent the encoder first side. To accomplish this, an input fiber first end is coupled to the light source while an end portion of an input fiber second end is inserted into the at least one recess of the first position assembly housing and secured at 922.
  • at least one output optical fiber optically couples a point adjacent the encoder second side and the light detector array. To accomplish this, an end portion of an output fiber first end is inserted into the at least one recess of the second position assembly housing and secured at 922 and an output fiber second end is coupled to the light detector array.
  • at least one lens is disposed adjacent thereto at 918.
  • the method may further comprise coupling a first control module to the light source and a second control module to the light detector array.
  • the method of fabrication is not limited to the particular order discussed above. As will be appreciated by those skilled in the art, the method of fabricating the position detection assembly may be performed in a variety of ways (e.g.., order of steps).
  • FIG- 10 is a flow diagram illustrating a method 1000 of detecting a position of a surgical instrument.
  • an encoder comprising a translucent substrate and one or more (unique) light blocking indicia (e.g., relative position indicia or absolute position indicia) is moved in concert with the surgical instrument.
  • the encoder is illuminated using a light source and at least one input optical fiber.
  • an input fiber first end is coupled to the light source and an input fiber second end is disposed adjacent an encoder first side.
  • light may be transmitted from the light source and directed through the encoder. Movement of the one or more light blocking indicia disposed on the translucent substrate interrupts such directed light from passing through the encoder.
  • the light passing through the encoder is detected using a light detector array and at least one output optical fiber. Detection of the light passing through may include, among other things, detecting the number of times that the light source is interrupted by the one or more light blocking indicia.
  • one or both of the relative or the absolute position of the surgical instrument is determined. Such determination includes the decoding of the detected light passing through a different part of the encoder.
  • the relative or absolute position of the surgical instrument is conveyed to a location outside of a magnetic field, such as a RF-field associated with a MRI scanner. In one example, the determination and conveyance of the position of the surgical instrument is performed using a control module coupled with the light detector array.
  • the present assemblies and methods provide real time remote position (e.g., depth) information of one or more surgical instruments (located within the typically strong magnetic field associated with MR imaging) to a surgeon (effectively) located outside of the magnetic field.
  • a surgeon effectively located outside of the magnetic field.
  • the present assemblies and methods have been discussed for utilization with neurosurgical apparatus, such assemblies and methods are not so limited. It will be appreciated by those skilled in the art that the present assemblies and methods may be utilized with other diagnostic or treatment apparatus, and that the magnetic environment about the subject may be an electrical/magnetic field other than an RF-field or similar created by a MRI scanner.
  • the present assemblies and methods include many other desirable characteristics including adequate patient isolation (e.g., from eddy currents) with gbod instrument performance.
  • the present assemblies and methods are easy and economical to manufacture, maintain, and use. It is to be understood that the above description is intended to be illustrative, and not restrictive. For example, the above detailed description may be used in combination with each other. Many other embodiments will be apparent to those of skill in the art upon reading and understanding the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of legal equivalents to which such claims are entitled.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • General Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Gynecology & Obstetrics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
  • Measurement Of Length, Angles, Or The Like Using Electric Or Magnetic Means (AREA)
  • Endoscopes (AREA)

Abstract

La présente invention concerne des ensembles et procédés pour détecter à distance la position d'un instrument chirurgical (102) en présence d'un champ magnétique. Un encodeur (126) est couplé pour se déplacer en même temps que l'instrument (102). Un substrat translucide et des marques de blocage de lumière (406) sont disposés sur l'encodeur (126). Une source de lumière (128) et une matrice de détecteurs de lumière (130) sont disposées efficacement à l'extérieur du champ magnétique. La lumière de la source de lumière (128) est envoyée vers le premier côté de l'encodeur au moyen d'une fibre optique d'entrée (120). La lumière traversant l'encodeur (126) est reçue sur un second côté de l'encodeur par une fibre optique de sortie (122), puis elle est transmise à la matrice de détecteurs de lumière (130) qui convertit la lumière reçue en signaux électriques représentant la position. De tels signaux sont alors transmis à un module de commande (134) qui formule et transmet la position de l'instrument (102).
PCT/US2006/049572 2005-12-30 2006-12-29 Detection de position dans un champ magnetique WO2007079222A2 (fr)

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US11/324,133 US7603161B2 (en) 2005-12-30 2005-12-30 Position detection in a magnetic field

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EP1974188B1 (fr) 2017-02-15
WO2007079222A3 (fr) 2007-09-07
US7603161B2 (en) 2009-10-13
US20090318799A1 (en) 2009-12-24
US20070167742A1 (en) 2007-07-19
EP1974188A2 (fr) 2008-10-01
US8706194B2 (en) 2014-04-22

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